Individual provider Active NPI

Michael McNeil

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1912423971
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT026067 Issued in PA
Practice address
169 W Durham St
Philadelphia, PA 19119-2433
Phone
(267) 551-0141
NPI assigned
Aug 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01750500 NJ
Physical Therapist 225100000X PT026067 PA Primary

Addresses

Primary practice location

169 W Durham St
Philadelphia, PA 19119-2433

Mailing address

169 W Durham St
Philadelphia, PA 19119-2433
Phone (267) 551-0141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181022000208 PA Practitioner - Physical Therapist in Private Practice 2466727698 Reassigns benefits to 2 organizations
I20200403000162 HI Practitioner - Physical Therapist in Private Practice 2466727698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01750500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pakolea LLC Physical Therapist CurrentSince Mar 13, 2020 Accepting new patients
Pennsylvania Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 13, 2023 Accepting new patients
Pursuit Physical Therapy Physical Therapist CurrentSince Feb 11, 2024 Accepting new patients
Fitlife Fitness & Aquatics, Incorporated Physical Therapist CurrentSince Aug 2, 2022 Accepting new patients
Esser Corp Physical Therapist Past Accepting new patients
PMR Medical and Diagnostic, PC PastSince Jul 21, 2022 Accepting new patients

Locations

194 Kilauea Ave
Apt 102
Hilo, HI 96720
Phone (808) 935-5255

740 Kilauea Ave
Hilo, HI 96720
Phone (808) 333-3420

300 Welsh Rd
Bldg 1
Horsham, PA 19044

7140 Germantown Ave
Philadelphia, PA 19119
Phone (215) 753-8910

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1912423971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 W DURHAM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192433",
            "telephone_number": "267-551-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 W DURHAM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192433",
            "telephone_number": "267-551-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEIL",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01750500",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.